School of Biomedical Engineering and Health Sciences, Faculty of Engineering, Universiti Teknologi Malaysia (UTM), Johor Bahru, Malaysia.
Renal Division, Department of Medicine, Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia.
Biomed Res Int. 2021 Jan 6;2021:6671552. doi: 10.1155/2021/6671552. eCollection 2021.
Minimal change disease (MCD) is the most common cause of idiopathic nephrotic syndrome in children, and it is well known for its multifactorial causes which are the manifestation of the disease. Proteinuria is an early consequence of podocyte injury and a typical sign of kidney disease. Steroid-sensitive patients react well with glucocorticoids, but there is a high chance of multiple relapses. CD80, also known as B7-1, is generally expressed on antigen-presenting cells (APCs) in steroid-sensitive MCD patients. Various glomerular disease models associated with proteinuria demonstrated that the detection of CD80 with the increase of urinary CD80 was strongly associated closely with frequent-relapse MCD patients. The role of CD80 in MCD became controversial because one contradicts finding. This review covers the treatment alternatives for MCD with the insight of CD80 as a potential therapeutic target. The promising effectiveness of CD20 (rituximab) antibody and CD80 inhibitor (abatacept) encourages further investigation of CD80 as a therapeutic target in frequent-relapse MCD patients. Therapeutic-based antibody towards CD80 (galiximab) had never been investigated in MCD or any kidney-related disease; hence, the role of CD80 is still undetermined. A new therapeutic approach towards MCD is essential to provide broader effective treatment options besides the general immunosuppressive agents with gruesome adverse effects.
微小病变性肾病(MCD)是儿童特发性肾病综合征最常见的病因,其多因素病因是其发病机制。蛋白尿是足细胞损伤的早期后果,也是肾病的典型标志。激素敏感患者对糖皮质激素反应良好,但多次复发的可能性很高。CD80 也称为 B7-1,通常在激素敏感 MCD 患者的抗原呈递细胞(APC)上表达。各种与蛋白尿相关的肾小球疾病模型表明,尿 CD80 的检测与频繁复发的 MCD 患者密切相关。CD80 在 MCD 中的作用存在争议,因为存在相互矛盾的发现。这篇综述涵盖了 MCD 的治疗选择,深入探讨了 CD80 作为潜在治疗靶点的作用。CD20(利妥昔单抗)抗体和 CD80 抑制剂(阿巴西普)的有前途的疗效鼓励进一步研究 CD80 作为频繁复发 MCD 患者的治疗靶点。针对 CD80(galiximab)的治疗性抗体从未在 MCD 或任何与肾脏相关的疾病中进行过研究;因此,CD80 的作用仍不确定。针对 MCD 的新治疗方法对于提供更广泛的有效治疗选择至关重要,除了具有可怕副作用的一般免疫抑制剂。